Individual
COLLIN ROSS BACKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
26297 139TH AVE, FORT RIPLEY, MN 56449-2060
(320) 630-7967
Mailing address
26297 139TH AVE, FORT RIPLEY, MN 56449-2060
(320) 630-7967
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
MN
171M00000X
Case Manager/Care Coordinator
—
MN
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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